双踝角测量及在先天性马蹄内翻足治疗中的应用_临床医学论文.docVIP

双踝角测量及在先天性马蹄内翻足治疗中的应用_临床医学论文 双踝角测量及在先天性马蹄内翻足治疗中的应用_临床医学论文 作者：杨璇 陈挺 范青 张自明 陆美玲 杜青 张菁 【关键词】 双踝角 　　摘 要：［目的］报道对正常婴幼儿足双踝角（FBM）的研究，并总结应用双踝角对先天性马蹄内翻足患儿病变程度进行分类与治疗评估的经验。［方法］测量足印长轴与内外踝的内上夹角为双踝角。2002年6月～2004年4月，测量正常儿140足(70人)，测量马蹄内翻足患儿60足(30人)。［结果］正常组婴幼儿足印双踝角平均865°，马蹄内翻足患儿足印FBM：Ⅰ类FBM角平均732°；Ⅱ类FBM角平均665°；Ⅲ类FBM角平均547°。所有经保守治疗成功病例治疗后FBM角平均844°，基本接近正常婴幼儿FBM值；先保守治疗再手术软组织松解的病例，术后FBM角平均785°，外观基本满意。其中全部Ⅰ类、80％Ⅱ类和30％Ⅲ类患足均经保守治疗获得满意疗效，20％Ⅱ类和70％Ⅲ类患足经保守治疗后因畸形矫正欠佳，再行软组织松解手术。［结论］采用FBM角对婴幼儿马蹄内翻足患儿畸形程度进行分类和治疗效果的评价是一种操作简便、客观、可重复使用的临床分类及评估标准，对于婴幼儿马蹄内翻足治疗前的评估和治疗方法的选择具有实际使用意义。 　　关键词：马蹄足； 双踝角； 足印 　　Application of foot bimalleolar measurement in the treatment of congenital talipes equinovarus 　　Abstract：［Objective］To study the measuring result of normal foot bimalleolar(FBM）angel in infants,and explore its application in the evaluation and identification of congenital talipes equinovarus pre and postoperatively［Method］The anteromedial angle between the long axis of foot and bimalleolar plane was measured as the FBM angleFrom June 2002 to April 2004,140 healthy feet of 70 infants aged from burn to 12 months were measured for FBMFBM angle of another 60 equinovarus feet of 30 infants with similar ages were measured for comparison and evaluation［Result］FBM angle of all healthy feet was average 865For the talipes equinovarus feet,the preoperative FBM angles were:average 732 in grade Ⅰ;665 in grade Ⅱ;547 in grade ⅢAfter surgical treatment,the FBM angle reached to average 844 in cases receiving successful conventional treatment,which was quite close to the normal value;the FBM angle reached to average 785 in cases receiving conventional treatment and soft tissue releaseSatisfactory result was achieved in all type Ⅰ cases,80% of type Ⅱ cases and 30% of type Ⅲ cases respectivelyExtra procedure of soft tissue release was given in the rest 20% of grade Ⅱ and 70% of grade Ⅲ［Conclusion］FBM measurement is a simple,objective and repeatable method for the clinical classification and evaluation of clubfootIt has si